Individual
KERRY CALHOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6800 SW 105TH AVE STE 206, BEAVERTON, OR 97008-5487
(708) 955-0912
Mailing address
14218 SW GOLD COAST TER, PORTLAND, OR 97224-5259
(708) 955-0912
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA219034
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/20/2021
Last updated
09/25/2024
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